Today at Doctor’s Choice Pharmacy, I had a conversation with a patient picking up a new prescription for Estradiol 10mg/mL cream. The instructions said:

“Apply 0.1 mL twice daily (2 clicks).”

She looked a little puzzled and asked, “What does ‘2 clicks’ mean? And why do I have to apply it twice a day?”

I smiled, glad she asked. “Each ‘click’ from your metered applicator dispenses 0.05 mL, so 2 clicks = 0.1 mL. Your prescription calls for 0.1 mL applied twice a day, which means 2 clicks in the morning and 2 clicks in the evening.”

She nodded slowly. “Okay, so I’m using 4 clicks total each day?”

“Exactly,” I said. “That gives you the full 2 doses of 0.1 mL, which delivers 1 mg of estradiol per dose based on your cream’s concentration of 10 mg/mL. That’s a total of 2 mg per day.”

Then she asked, “Why does my doctor want me to use it twice a day instead of once?”

“That’s a great question,” I said. “In bioidentical hormone therapy, smaller, more frequent doses can mimic your body’s natural hormone rhythms. Applying it twice daily helps keep your estradiol levels more consistent throughout the day, which can help with symptoms like:
✔ Hot flashes
✔ Mood swings
✔ Sleep issues
✔ Vaginal dryness
✔ Low energy”

She asked, “Can I apply it anywhere?”

“Your provider may have instructed you to apply it to the inner forearms, inner thighs, or vaginal area, depending on your needs. Always make sure the area is clean and dry, and avoid applying near broken or irritated skin.”

Before she left, I reassured her, “And if you ever need a refill, we compound this estradiol cream fresh, using high-quality, hypoallergenic ingredients—and yes, we offer free delivery!”

She smiled, feeling more confident. “That makes so much more sense now—thank you, Rania!”

At Doctor’s Choice Pharmacy, we’re always here to make sure you understand every detail of your hormone therapy—because personalized care starts with clear guidance.

Until tomorrow,
Rania – Your Friendly Pharmacist at Doctor’s Choice Pharmacy

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